There is always an impetus, a moment of inspiration, that leads to thoughts and expressed in my writing here. This time, my son Ramsey and his girlfriend, Kate, were visiting and they choose the movie, Eight Grade, for our Saturday night movie night. I wasn’t excited by the choice based on the fact I had never heard of it, and secondly, I’ve watched other “coming of age” middle school or high school films, that left me less than impressed. Often somewhat silly. But this time, this film was different.
First of all, the acting by Elsie Fisher as the protagonist, Kayla, was superb. She was so realistic in this role that I had to keep reminding myself that this was a fictional film, not a documentary.
I have long heard that middle school girls face an incredibly brutal rite of passage. I raised one girl and I, briefly, coach a middle school girl’s basketball team. So, I had observed the dynamics from a distance. I have had countless middle school girls as patients … and their mothers. I’ve heard the horror stories, so extreme that I had to deal with their suicidal ideation.
Middle school boys have their own rite of passage, deserving their own movie to show what it is like. I’m sure several have been made to cover that perspective. Within that world, boys face a constant treat of physical violence and homophobic insults. But I don’t know which is worse, having your face punched in or your ego trampled by a group of girls.
Kayla is struggling to feel significant in a world that does not value her (or anyone). It is a profoundly difficult course to navigate. The most poignant scene, in my opinion, is where she has created a YouTube channel where she gives advice to other young girls. That is her one contribution to the world. The thing that gives her value. When she checks on her videos, some weeks old, you can see the indicator beneath her video that it had “0 views” or “1 view.” In that latter case, the one view as probably her own, checking to see how it appears.
I had a friend once who was a frequent Face Book poster, then one day, out of the blue, she posted a very angry post asking why does no one on Face Book likes her, or comment on any of her postings. She expressed openly what most of us fee at time.
About fifteen years ago I was writing a very heavy book. I spent ten years doing research on it. I came up with one question that gripped my consciousness for a year. That question was, “What is the fundamental basis for human behavior?” It was a process where I, like the astrophysicist seeking a unified theory of everything (Newtonian and Quantum Mechanics combined), was seeking one simple description of what makes all of us tick. The answer I arrived at, after tremendous amount of thought, was that the fundamental motivation for everything was our personal quest for significance. It was to me what the superego, ego, and id was to Freud.
For most of my life, both in the pop-culture realm and in the professional realm, I was presented with the idea that only a small percentage of people struggle with a low self-esteem. Just like a small percentage of people struggle with severe anxiety … or Lupus. That everyone else was spared. But now, I don’t think that is true at all.
We are all born into a “me-centric” universe (except for those abused at an early age). It is during the “terrible twos” that we start to adjust to reality, where we compete for the attention of our parents with other siblings, other people, and other things. We then spend the rest of our lives trying to achieve a place where we feel significant in a very busy and competitive world. No one is spared, although some may deal with this more than others … or maybe not.
If you go to a party and you see a couple of people sitting off by themselves, talking to no one, and you see a loud mouth at the center of the room going on and on about their wealth, their jobs, their perfect families, and great accomplishments; they both are dealing with a severe low self-esteem, or a fear of insignificance, but in different ways. Those that we assume are least conscious of a low self-esteem, the confident and loud, are often the worst. Narcists are the most insecure people in my opinion. They demand to be worshiped and anything less is not enough to fill their void.
But, my point is that we all fight this fight. This quest is the source of our desire for schooling, for professions, for families, for athletes, for artists, all wanted the world to see their accomplishments, and to say, “Because of your contribution, you have value.”
I suspect that most depression, most anxiety is a spin off of this quest. If there is a root of all evil, it is not money, but the feeling of insignificance. That has been the MO of the school shooters, those who abuse others, those who start wars. Money appears to be the root of all evil because money is simply a tool (false tool) for measuring one’s significance within our social structures.
If you doubt my perspective, that all of us battle for significance, then imagine the following scenario. Imagine that it is a milestone birthday for you. A significant other person plans a huge birthday bash for you (not a surprise party) and invites the whole community, your relatives, and friends. There are flyers up on every telephone pole. You feel embarrassed by the effort. Then the day comes, and not one person shows up. Who is so secure that they would not feel the pain? Who would not doubt their significance? Few if any.
I will make this more practical. How many people look in a mirror and always like what they see? Not many. For the rest of us, we look too fat, too skinny, too ugly, too old, too short, too tall, too pimpled, or scarred. But that is only within the realm of appearance. Then venture into other areas of talents or accomplishments, and it is the same. If you go to the real inner person, the candid person that no one else really knows, you would see these insecurities playing out. What makes this worse is feeling that you are the only one with this struggle. That the perfect people chosen (and then well decorated with make up and special lighting) on TV or the movies are the average.
Illness and the Search for Significance
A long time ago, when I was working at Mayo Clinic, I had a patient who had been the CEO of a very large organization when she only in her thirties. She was also a marathon runner, writer, rock climber, adventure traveler, and artist. Then one day, suddenly she became gravely ill. I can’t remember what the disease was, but I think it was a new and severe onset of Multiple Sclerosis. She went from being a very successful person to being bed-bound for a year. Her friends (she was single) were at her side for a couple of weeks, but began dropping off one by one. When her recovery didn’t happen quickly, she was replaced in her CEO position. Then her on-off boyfriend, became permanently off, seeking a healthier girlfriend. Within months, she was in complete isolation … save one close friend who would visit now and then, and a paid care-giver who was there daily.
I was completely enthralled with her story and listened with my chin on my fists, my elbows on my thighs, me leaning in her direction, groping for each word.
Soon, she was so helpless that she had a home health aid that helped her get on the bedside toilet a few times per day, fed her Ensure through a straw, and … wiped her butt for her. It was at this point (not surprisingly) she became very depressed. She expressed her depression in clear terms, she felt worthless. She brought no significance to the world anymore. I’ve always said that suicide often comes after the conclusion that you bring no value to this world. She said the only thing that kept her from suicide was the inability to walk and move her arms (it is hard to kill yourself when you can’t move).
Some people would point at her previous life and say she had her priorities wrong to start with. I’m here to say that all of us would be in the same place as her, in her situation. That the idea that we are better than her, is part of this same quest to feel significant. I know that when I heard her story, I felt this could never happen to me because I was smarter, more balanced and etc. I also considered myself more spiritual than her, not allowing such negative thoughts.
This woman described to me her long and tough mental battle. The risk to her life was not her MS as much as her will to live. She finally arrived at a juncture where she realized that God had created her in his image, and in that alone, she had great intrinsic value. That became her meditative mantra. But even that mind game is hard to maintain. She did recover physically, not fully, but where she could walk again and go back to work. But she lost her drive to succeed, in a good way. She became more content without visible accomplishments to give her life meaning.
On this side of a sudden onset of the failure of health and life, I now think about this lady and her experience and how I am not spared from her ordeal, the way that I assumed my “good character” would spare me. My physical battle against cancer pales to the mental battle I have of finding significance in this post-disease-onset world. The battle is constant and severe at times, especially at night. I sense, and I fear, that I no longer have value in my family, or the world. I feel that everyone has stopped talking to me. Am I now just the elephant in the room, the enigma, the pathetic scrawny cat that you put in a shoebox, under the bed, in a spare bedroom, because they are too hideous to look at? My point with this statement is not for pity, but to show how serious this battle is for all of us who have suddenly lost what we thought gave us significance. Even if this is only a figment of my imagination, it is no less a battle … a battle for my soul and a will to live.
Having lived in the cancer world for almost three years now, I’ve watched several people die, and I don’t think it was really their cancer that killed them, but their lack of will to live and to take care of themselves anymore. When you feel you have no significance anymore, you loose the will to continue.
The Flaw of the Christian / Islamic Perspectives
I have certainly heard the concept that I’m about to describe from both Muslims and Christians.
Back in the early 1990s, we were in a group study as part of an evangelical church. That study was entitled, “Search for Significance.” To summarize a twelve week course is that only a few people suffer from a low-self esteem, and that is due to the sin of self-centerless. The solution is realizing that all people really are completely worthless. Scum in other words. Actually we are all profoundly evil, deserving to be punished by the unrelenting fries of hell for all of eternity. That God, by his good mercy alone, has chosen us to be on the good side, but it is not based on any merit of our own, as we are still intrinsically worthless, except for being created by God.
Maybe, if you were a great computer designer and you created a computer that was completely worthless, even evil at its core (couldn’t even do basic arithmetic without making mistakes) maybe someone would place value on that computer because it was created by you … but only those who collect vintage computers, not those you actually use them.
My point is, this “Intrinsic value but otherwise garbage” view of the self that the Abrahamic faiths promote, is not healthy. I now find this perspective profoundly pathologic. However, to try and inject meaning or worthiness into our being from any other perspective, is considered “Humanistic.”
But let’s be honest. Even the devout Christian or Muslim, who claims no value but the intrinsic value of creation, don’t believe this in their hearts. They still constantly measure themselves as compared to other Christians or Muslims. Like with the narcists, they may sometimes have the worst self-valuation and insecurity, which they try to make up for by legalisms. They only vote a certain way, avoid saying certain words like “shit,” try to appear sweet and nice, and etc. All in a game to feel a great significance.
So, what is the solution? I love candor. We have to find this balance where we do count our existence with intrinsic value but we also add in our accomplishments. We must give credit or what we’ve done. This should not be an offense to God in any more way than a great running computer is an offense to the computer-maker.
The other mistake these faiths make is referencing the “other world” be it Heaven or whatever, prematurely. Certainly I can see the discussion of the afterlife when someone is on their deathbed, one foot in the grave with no way out. But to start telling someone who is sick and fighting, about how they can look “forward to being with Jesus soon,” is a way of say, “You no longer have any value in this physical world.”
Lessons from The Personal Battle
When I was first diagnosed and admitted to the hospital, my life in the balance, a brand new nurse (maybe 21) said something to me … an I thought she got it very wrong.
“How old are you?” she asked.
“I am 64, I murmured.”
“Well, you’ve lived a good life. I saw your kids that you must be proud of. No one would blame you if you decided not to fight this cancer and just go.”
I said to her, “So, I was just diagnosed with cancer yesterday and you now say I have no value and should end my life?”
“Something like that,” she said.
I had many nurse who said much better things to me, but this conversation I will not forget.
So, I’ve learned a lesson from my migraine patients. It is my only way forward, if I am going to survive this. A migraine patient made a short film that won an award. In that film, she portrayed herself, not as a victim spending her days in a dark room, but as a super hero. She had super powers, fighting against the villain, migraine. In the last frame of the movie she was standing, fists on her hips, legs apart, cape blowing in the wind, in that classic superwoman pose.
I was inspired by that and bought a cape that superman or woman would wear. When I noticed my patients either being discouraged (but having fought a tremendous fight) or having reached a great success, I would go down to my office and get the cape and put it on them. I know it sounds silly, and I would only do it to patients that I thought would understand the gesture. But I wanted them to see themselves as the hero, the superhero who has fought a tremendous fight. Even if their husbands or mother-in-laws were saying they were lazy or not really suffering. But they were more successful than the one who only made a billion dollars, or won a gold metal at the Olympics. That they did have value in their creation an existence, but also with their ability to see their accomplishments, even accomplishments otherwise unnoticed in the normal world.
If I survive this, I must find this path. The path that, despite how the world measures success and value, that I still have some. That I must look to my daily, private fight as proof that I still exist that I still have significance in this world that screams I don’t. I must make it my mantra that, while if feels like I’ve lost everything, I still have worth in this world. Otherwise, the loss of the will to live will be my ultimate downfall. This is the battle of Ephesians 6:12, not against flesh and blood, but against thoughts, emotional forces, and ideas.
I think the greatest medicine isn’t humor, or drugs, but the ability of doctors, nurses, family members, or friends to convey the message that despite what someone is facing, mental or physical, that they still have significance and value in this world. It is the CPR of the soul.